Subungual myxoid cysts: clinical manifestations and response to therapy

J Am Acad Dermatol. 2002 Mar;46(3):394-8. doi: 10.1067/mjd.2002.119652.


Background: Myxoid cysts located beneath the nail are very different from those within the nailfold and there is no established literature on their diagnosis and therapy.

Objective: Thirty-five cases of subungual myxoid cyst are described in which the diagnosis was confirmed by magnetic resonance imaging, surgical exploration, or both.

Methods: The clinical characteristics of all cases of subungual myxoid cysts confirmed in 3 specialist nail clinics are reported. Twenty cases were confirmed by magnetic resonance imaging. Histologic details were recorded in 4 cases.

Results: Thirty-four patients (22 female, 12 male) presented with a subungual tumor of the thumb (n = 25) or finger (n = 10). The 3 main clinical variables were color of the lunula, transverse nail curvature, and integrity of the nail. In 26 cases the lunula was discolored; it was red in 22 cases, blue in 3, and as part of a longitudinal leukonychia in one. Transverse curvature was increased in 29 cases and was normal in 5 cases; in one case the nail was destroyed. In 11 cases, the change in curvature led to lateral ingrowing. Surgery (n = 22), sclerosant (n = 1), and spontaneous discharge (n = 2) all resulted in resolution. Ten patients had no treatment.

Conclusion: This study describes 35 subungual myxoid cysts having characteristic features that allow clinical diagnosis. They respond to a range of treatments.

MeSH terms

  • Adult
  • Aged
  • Female
  • Fingers
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nail Diseases / diagnosis*
  • Nail Diseases / surgery
  • Synovial Cyst / diagnosis*
  • Synovial Cyst / surgery
  • Thumb